To evaluate effectiveness of yoga as an adjuvant to conventional medical management on clinical outcomes in patients with migraine.

CONTAIN was a prospective randomized, open label, superiority trial with blinded endpoint assessment carried out at single tertiary care academic hospital in India. Patients enrolled were aged 18–50 years with a diagnosis of episodic migraine and were randomized into medical and yoga group (1:1). Randomization was computer generated with a variable block size and concealed. Predesigned yoga intervention was given for 3months. Outcomes were recorded by blinded assessor. Primary endpoint was a decrease in headache frequency, headache intensity and HIT–6 score. Secondary outcomes included change in MIDAS score, pill count and proportion of headache free patients. CTRI/2017/03/008041

Between April 2017 and August 2018, 160 patients of episodic migraine were randomly assigned to medical and yoga group. 114 patients completed the trial. Baseline parameters were comparable except a higher mean headache frequency in the yoga group. Compared to medical therapy, yoga group showed a significant mean delta value reduction in headache frequency (delta difference: 3.53 [95% CI 2.52–4.54]; P<0.0001), headache intensity (1.31 [0.60–2.01] P=0.0004), HIT score (8.0 [95% CI 4.78–11.22]; P<0.0001), MIDAS score (7.85 [4.98-10.97]; P<0.0001) and pill count (2.28 [1.06 to 3.51]; P<0.0003).

Yoga as an add on therapy in migraine is superior to medical therapy alone. It may be useful to integrate a cost effective and safe intervention like yoga in the management of migraine patients.